06 October 2008

Deb Acle over at the Jobbing Doctor has pointed out that the sort of things the government has been up to in the NHS it has been up to all over the place. Dr Grumble is aware of this. He has friends who are teachers and lawyers. When Dr G moans to them they chorus that the government is doing the same to them. There was a good example on the Today programme this morning.

If you are a doctor you may not have heard of Criminal Defence Service Direct. But it may sound familiar. If you are a criminal in trouble you used to be able to phone your very own solicitor. And you could have a face to face meeting with him. In future you will phone Criminal Defence Service Direct for advice. They won't come and see you. They will give advice. The advice may be from somebody who is not a solicitor. Does that sound familiar? You used to be able to have your very own solicitor come and see you but in future you will get somebody who is not a solicitor over the phone. The similarity with NHS Direct is striking. The common factor is that this has been imposed by the government according to the exact same formula dreamed up by policy wonks who have probably never worked as a solicitor just as those who advised the government on general practice have never worked as a doctor. The powers-that-be probably think it will be cheaper. Many doctors think NHS Direct was money down the drain. What do the solicitors think about Criminal Defence Service Direct? They certainly seem to think it offers a dumbed down poor quality service that their clients just do not like. And Dr Grumble would be surprised if it really saves money. Paying people to do a poor job rarely saves money. As Red Adair said:

If you think it's expensive to hire a professional to do the job, wait until you hire an amateur.

I think NHS direct is an excellent service for the worried well and is a great help to locate service but to think it will save money is a joke: I think it will drive up consumption of other services.

Really glad I don't have children and am keeping it that way. Can't get arrested and continue in my profession, let alone charged so I hope that I never need the CPS

I guess the goal of the current government is to ensure that everybody receives the same standard of care regardless of how good the standard is as cheaply as possible while creating jobs for as many cronies as possible: and the say Mugabe is bad!

This is happening to the law in just about every respect. Essentially, there is no access to legal remedy unless you are a criminal or, as a law-abiding citizen, have shedloads of money.

As JD says, real education is being obliterated by 'teacher practitioners' (akin to 'nurse practitioners'). Both flavours of skill and knowledge level are being paid at a fraction of the cost of real teachers and real doctors.

I must say that the people at NHS Direct are genuinely good at their roles. I've had great advice and support from them on occasion. But, their understanding of what it's like out here in Real Life is very limited. They don't seem to realise that their scripts say 'This, that, the other should happen now as a result of this call' and it never does (well, maybe if you're impaled on railings and bleeding heavily in a public place...then an ambulance turns up. Usually.)

As you say, it's an entirely false economy. We're beginning to pay the price now.

I've been working my way back through your blog having found it earlier today. So much interesting food for thought.

I would only say that my own (and my family's) experiences of NHS Direct have been very good. I've found that both times the people who called me back (whoever they were) gave me useful advice. It's possible that the NHS Direct website saved my dad's life by correctly diagnosing his heart attack... only my dad would log on to a website to discover he was having a cardiac arrest!